# G4 ATHLETE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** G4 Athlete
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740689520
- **Authorized official:** MR. BRENT M GEORGE MPT (PHYSICAL THERAPIST/CLINIC OWNER)
- **Authorized official phone:** (206) 518-9405

## Contact information

- **Practice address:** 2737 77TH AVE SE, SUITE 214, MERCER ISLAND, WA 98040-2830
- **Practice address phone:** (206) 518-9405
- **Practice address fax:** (855) 819-0086
- **Mailing address:** 2737 77TH AVE SE, SUITE 214, MERCER ISLAND, WA 98040-2830
- **Mailing address phone:** (206) 518-9405

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251S0007X | Sports Physical Therapist | 603186027 | WA | Yes |

## Other

- **Enumeration date:** 08/18/2014
- **Last updated:** 08/18/2014